Home-based Gait and Balance Training in Patients With Movement Disorders

Comparison of Two Home-based Gait and Balance Trainings With Different Training Frequencies in Patients With Parkinson's Disease and Ataxia

The research project is an experimental study with three study visits at the study site at the University Hospital Düsseldorf (UKD) / Heinrich Heine University Düsseldorf (HHU) and a three-week training phase in a parallel design. Patients with movement disorders (ataxia or Parkinson's disease) can take part. The training phase includes individually adapted, targeted, video-based coordination and balance training, which should lead to an improvement in gait and balance. Two different training protocols are carried out in parallel for three weeks each: One with 20 minutes of training per day, four days per week; and one with a training duration of 40 minutes per day, only two days per week. All patients initially take part in a one-week familiarization phase without training and are then randomly assigned to one of the two training protocols or the control group without additional training. In both training phases, the total amount of weekly training time is the same, but the frequency and duration of training sessions per week differs. The patients who were assigned to the control group without additional training can complete the training after their third study visit.

Study Overview

• Status: Recruiting
• Conditions: Parkinson Disease; Ataxia
• Intervention / Treatment: Other: Gait and balance training

Detailed Description

It will be investigated separately for the two patient groups (ataxia, Parkinsons disease), whether the video-based training can lead to an improvement in gait and balance and whether the training protocols differ with regard to the desired improvement. The gait and balance variables recorded using the two standard methods (force plate, motion capturing system) will serve as the basis for assessing the training effect. Furthermore, the investigators want to analyze how the individual variables differ between the healthy subjects (from our previous study) and patients with movement disorders.

Patients can also voluntarily record movement data using their own smartphone. This has the advantage that data can also be collected at home, which is more likely to reflect the everyday life of the participants. In particular, the aim is to check whether the data collected with the smartphone can also be read and analyzed in patients, despite the increased movement variability, and whether typical movement patterns and training-related changes can be recorded.

Only adults will take part in the study. The aim is to assess 21 patients with cerebellar ataxia or idiopathic Parkinsons disease per group. This number is based on a power calculation with the software G*Power 3.1.9.7 (Test family t tests, Means: Difference between two independent means (two groups)), with one-sided significance with α = 0.05, 1-β = 0.8 and a calculated effect size of 0.8. Participants in the study will be fully informed in advance about the study procedure. Participation in the study is voluntary. Participants can withdraw from the study at any time without giving reasons and without any disadvantages. A clinical diagnosis of cerebellar ataxia or idiopathic Parkinsons disease is a prerequisite for participation in the study. Participants must also be able to walk independently for 2 minutes. Exclusion criteria are other diseases with an impact on motor skills or serious primary psychiatric illnesses, current drug or alcohol dependency, consumptive illnesses or a poor general condition. There must be no increased risk of falling. Parkinsons patients should carry out the measurements on site and at home during the on-phase of the medication, approx. 2 hours after taking the medication. Patients are recruited via the special outpatient clinic for movement disorders at the Institute for Movement Disorders and Neuromodulation at the UKD / HHU Düsseldorf.

The study is discontinued for the individual study participant if an increased risk of falls becomes apparent. The study as a whole will be discontinued if it becomes apparent that the risks of the study outweigh the benefits or if unforeseen complications arise during the training phase.

• Study Type: Interventional
• Enrollment (Estimated): 80
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Martina Minnerop, PD Dr. med.; Phone Number: +49246161-2125; Email: m.minnerop@fz-juelich.de
• Study Contact Backup: Name: Clara Rentz, M. Sc.; Phone Number: +492461612125; Email: c.rentz@fz-juelich.de

Study Locations

• Germany
  • NRW
    • Düsseldorf, NRW, Germany, 40225
      • Recruiting
      • Universitätsklinikum Düsseldorf, Institut für Klinische Neurowissenschaften und Medizinische Psychologie
      • Contact: Martina Minnerop, PD Dr. med.; Phone Number: +49 2461 61 2125; Email: m.minnerop@fz-juelich.de
      • Contact: Clara Rentz, M. Sc.; Phone Number: +49 2461 61 2125; Email: c.rentz@fz-juelich.de
      • Principal Investigator: Martina Minnerop, PD Dr. med.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• clinical diagnosis of cerebellar ataxia or idiopathic Parkinson's syndrome
• opportunity to walk a distance of four meters unhindered at home

Exclusion Criteria:

• other diseases with an impact on motor skills
• severe primary psychiatric illnesses
• current drug or alcohol addiction
• consumptive diseases
• poor general condition
• increased risk of falling (anamnestic fall frequency of ≥ 1x per week or as assessed by the attending physician)
• incapacitated patients in official or court custody or patients unable to give consent
• for PD patients taking medication: not being able to carry out the measurement in the on-phase of the medication

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 4 x 20 minutes training per week; During the three-week training phase, the video-based training should be carried out at home four times a week for 20 minutes each time. The access to the training videos is provided via links.	Other: Gait and balance training; The training includes individually adapted, targeted, video-based coordination and balance training, which should lead to an improvement in gait and balance. It includes strength, coordination and flexibility exercises.
Experimental: 2 x 40 minutes training per week; During the three-week training phase, the video-based training should be carried out at home two times a week for 40 minutes each time. The access to the training videos is provided via links.	Other: Gait and balance training; The training includes individually adapted, targeted, video-based coordination and balance training, which should lead to an improvement in gait and balance. It includes strength, coordination and flexibility exercises.
No Intervention: control group; During the three weeks between study visit two and study visit three, no additional training is conducted. Patients who were assigned to the group without training are given access to the training material after the end of the study and can carry it out afterwards.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
gait velocity	measured in m/s, measured by a force plate (zebris), a motion capturing system (Xsens) and individual smartphones of the participants at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
stride time	time needed for one stride (two steps) measured in s, measured by a force plate (zebris), a motion capturing system (Xsens) and individual smartphones of the participants at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
step width	measured in cm, measured by a force plate (zebris), a motion capturing system (Xsens) and individual smartphones of the participants at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
cadence	number of steps per second, measured in s^-1, measured by a force plate (zebris), a motion capturing system (Xsens) and individual smartphones of the participants at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
Lat Step Dev	Lateral Step Deviation / step width variability (SD / CV), measured in cm, measured by a force plate (zebris), a motion capturing system (Xsens) and individual smartphones of the participants at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
Toe Out Angle	Foot rotation, measured in degrees, measured by a force plate (zebris) and a motion capturing system (Xsens) at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
Double Support Time	Double Support Time, measured percentage of whole gait cycle, measured by a force plate (zebris) and a motion capturing system (Xsens) at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
Toe Off Angle	Take off angle of foot at "toe off" position, measured in degrees, measured by a motion capturing system (Xsens) at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
sway area	Center of mass / center of pressure 95% ellipse area, measured in mm2, measured in all stance tasks by a force plate (zebris), a motion capturing system (Xsens) and individual smartphones of the participants at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	rom enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
sway velocity	Center of mass / center of pressure path length per time, measured in mm/s, measured in all stance tasks by a force plate (zebris), a motion capturing system (Xsens) and individual smartphones of the participants at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
sway path	Center of mass / center of pressure path in xy-plane, measured in mm, measured in all stance tasks by a force plate (zebris), a motion capturing system (Xsens) and individual smartphones of the participants at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
arm-pelvis distance	Distance from the arms to the pelvis, measured in mm, measured in all stance tasks by a motion capturing system (Xsens) at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
foot elevation	maximum foot elevation during gait, measured in cm, measured in all gait tasks by a motion capturing system (Xsens) at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
trunk ROM	Trunk range of motion in xy-plane, measured in mm, measured by a motion capturing system (Xsens) and individual smartphones of the participants at week 0, at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
UPDRS score	Unified Parkinson Disease Rating Scale, assessed via neurological examination at week 0, after training or no training (week 4) and after training for the control group (week 7), only for the patient group of Parkinsons Disease. A higher score means a worse outcome. Range: 0-76	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
Hoehn and Yahr score	Hoehn and Yahr scale, assessed via neurological examination at week 0, after training or no training (week 4) and after training for the control group (week 7), only for the patient group of Parkinsons Disease. A higher score means worse outcome. Range: 0-5	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
SCAFI score	Spinocerebellar Ataxia Functional Index, assessed via neurological examination at week 0, after training or no training (week 4) and after training for the control group (week 7), only for the patient group of Ataxia. Separate values are reportet for the 8-meter-walk-test (8MW, in seconds, higher score means worse outcome), 9-hole pegboard test (9HPT, in seconds, higher score means worse outcome) and PATA task (PATA, number of repetitions, higher score means better outcome).	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
FARS-ADL score	Activities of daily living, Rating Scale for Friedreichs Ataxia, assessed via neurological examination at week 0, after training or no training (week 4) and after training for the control group (week 7), only for the patient group of Ataxia. A higher score means worse outcome. Range: 0-36.	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
EQ-5D-SL score	Quality of life questionnaire, assessed via questionnaire at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7). Health status is assessed in % from 0-100, a higher score means better outcome.	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
TUG time	time to complete Timed Up and Go test, assessed via neurological examination at week 0, after training or no training (week 4) and after training for the control group (week 7). Measured in seconds, a higher score means a worse outcome.	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
FAHW score	Fragebogen zum allgemeinen habituellen Wohlbefinden (general habitual well-being questionnaire), assessed via questionnaire at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7). A higher score means better outcome.	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
ABC-D score	German version of the Activity-Specific Balance Confidence scale, assessed via questionnaire at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7). Measured in mean %, a higher score means a better outcome. Range: 0-100.	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
MSWS-12	German Version of Multiple Sclerosis Walking Scale, assessed via questionnaire at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7). A higher score means a worse outcome. Range: 12-60.	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
PDQ-39	Parkinsons Disease Questionnaire, assessed via questionnaire at baseline (week 1), after training or no training (week 4) and after training for the control group (week 7), only for the patient group of Parkinsons Disease. A higher score means a worse outcome. Range: 0-156.	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
PGIC	Patient global impression of change (7-point Likert scale), assessed via questionnaire, after training (week 4) or after training for the control group (week 7). A higher score means a better outcome. Range: -3 to 3 for each item.	At the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)
SARA score	Scale for the Assessment and Rating of Ataxia, assessed via neurological examination at week 0, after training or no training (week 4) and after training for the control group (week 7), only for the patient group of Ataxia. A higher score means a worse outcome. Range: 0-40.	From enrollment to the end of intervention at 4 weeks (training groups) / at 7 weeks (control groups)

Collaborators and Investigators

• Sponsor: Forschungszentrum Juelich
• Collaborators: Heinrich-Heine University, Duesseldorf
• Investigators: Principal Investigator: Martina Minnerop, PD Dr. med., Institut für Neurowissenschaften und Medizin (INM-1), Forschungszentrum Jülich GmbH

Publications and helpful links

General Publications

• Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175-91. doi: 10.3758/bf03193146.
• Miyai I, Ito M, Hattori N, Mihara M, Hatakenaka M, Yagura H, Sobue G, Nishizawa M; Cerebellar Ataxia Rehabilitation Trialists Collaboration. Cerebellar ataxia rehabilitation trial in degenerative cerebellar diseases. Neurorehabil Neural Repair. 2012 Jun;26(5):515-22. doi: 10.1177/1545968311425918. Epub 2011 Dec 2.

Study record dates

Study Major Dates

• Study Start (Actual): January 4, 2023
• Primary Completion (Estimated): December 1, 2025
• Study Completion (Estimated): December 1, 2025

Study Registration Dates

• First Submitted: September 20, 2024
• First Submitted That Met QC Criteria: September 20, 2024
• First Posted (Actual): October 1, 2024

Study Record Updates

• Last Update Posted (Actual): August 13, 2025
• Last Update Submitted That Met QC Criteria: August 8, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: Training; movement disorders; PD; home-based; Parkinsons Disease; Ataxia; video-based; motion capturing
• Additional Relevant MeSH Terms: Synucleinopathies; Neurologic Manifestations; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurodegenerative Diseases; Parkinsonian Disorders; Basal Ganglia Diseases; Dyskinesias; Cerebellar Diseases; Movement Disorders; Parkinson Disease; Ataxia; Cerebellar Ataxia
• Other Study ID Numbers: 2022-1994

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Anonymized, aggregated data can be provided upon request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No